痴呆亚型与自杀倾向：一项系统综述和荟萃分析。

Dementia subtypes and suicidality: A systematic review and meta-analysis.

作者信息

Nuzum Eleanor, Medeisyte Radvile, Desai Roopal, Tsipa Anastasia, Fearn Caroline, Eshetu Aphrodite, Charlesworth Georgina, Stewart Gavin R, Crutch Sebastian J, El Baou Céline, Kurana Suman, Brotherhood Emilie V, Flanagan Katie, Salmoiraghi Alberto, Kerti Amy, Stott Joshua, John Amber

机构信息

ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK.

ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK; Research and Development, North East London NHS Foundation Trust, London, UK.

出版信息

Neurosci Biobehav Rev. 2025 Feb;169:105995. doi: 10.1016/j.neubiorev.2024.105995. Epub 2024 Dec 31.

DOI:10.1016/j.neubiorev.2024.105995

PMID:39746589

Abstract

AIMS

Recent research has highlighted a link between dementia and increased risk of suicidal ideation, suicide attempts and suicide deaths. Understanding the relative risk of suicide between subtypes of dementia is important for services to offer appropriate intervention.

METHOD

We searched five databases from inception to July 2023 for peer-reviewed publications reporting suicidal ideation, suicide attempt or death by suicide for at least two dementia subtypes. Meta-analyses compared suicidality between subtypes of dementia with Alzheimer's Disease (AD).

RESULTS

From 4983 studies identified, 12 met inclusion criteria. Pooling data, people with Vascular Dementia were significantly more likely to experience suicidal ideation (OR= 2.02 [95 % CI= 1.06;3.8]) and attempt suicide (OR=1.94 [95 % CI= 1.28;2.94]) than people with AD, but not die by suicide (OR= 1.05 [95 % CI= 0.69;1.59]). People with Dementia with Lewy Bodies were significantly more likely to report suicidal ideation (OR= 1.56 [95 % CI= 1.09;2.23]) than AD but not attempt suicide (OR= 1.12 [95 % CI= 0.83;1.50]). People with Frontotemporal Dementia were significantly more likely to attempt suicide (OR= 2.42 [95 % CI= 1.02;5.72]) than people with AD but not report suicidal ideation (OR= 1.67 [95 % CI= 0.34;8.33]). People with Mixed Dementia were significantly more likely to attempt suicide (OR= 2.83 [95 % CI= 1.52;5.27]) than people with AD but not report suicidal ideation (OR = 1.65 [95 % CI= 0.5;5.46]).

CONCLUSIONS

Further research is needed to understand what underlies the increased risks of suicidal ideation and suicide attempts for rarer subtypes.

摘要

目的

近期研究强调了痴呆症与自杀意念、自杀未遂及自杀死亡风险增加之间的联系。了解痴呆症各亚型之间的相对自杀风险对于提供适当干预措施的服务而言至关重要。

方法

我们检索了从数据库建立至2023年7月的五个数据库，以查找至少报告了两种痴呆症亚型的自杀意念、自杀未遂或自杀死亡情况的同行评审出版物。荟萃分析比较了痴呆症各亚型与阿尔茨海默病（AD）之间的自杀倾向。

结果

在识别出的4983项研究中，12项符合纳入标准。汇总数据显示，血管性痴呆患者出现自杀意念（比值比[OR]=2.02[95%置信区间（CI）=1.06；3.8]）和自杀未遂（OR=1.94[95%CI=1.28；2.94]）的可能性显著高于AD患者，但自杀死亡的可能性并不高于AD患者（OR=1.05[95%CI=0.69；1.59]）。路易体痴呆患者报告自杀意念（OR=1.56[95%CI=1.09；2.23]）的可能性显著高于AD患者，但自杀未遂的可能性并不高于AD患者（OR=1.12[95%CI=0.83；1.50]）。额颞叶痴呆患者自杀未遂（OR=2.42[95%CI=1.02；5.72]）的可能性显著高于AD患者，但报告自杀意念的可能性并不高于AD患者（OR=1.67[95%CI=0.34；8.33]）。混合性痴呆患者自杀未遂（OR=2.83[95%CI=1.52；5.27]）的可能性显著高于AD患者，但报告自杀意念的可能性并不高于AD患者（OR=1.65[95%CI=0.5；5.46]）。